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高龄产妇体外受精-胚胎移植妊娠与自然妊娠的妊娠结局比较。

Comparison of pregnancy outcomes between IVF-ET pregnancies and spontaneous pregnancies in women of advanced maternal age.

作者信息

Lang Manning, Zhou Meiying, Lei Ruobing, Li Weihong

机构信息

Reproductive Medical Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

J Matern Fetal Neonatal Med. 2023 Dec;36(1):2183761. doi: 10.1080/14767058.2023.2183761.

Abstract

AIM

To explore the impact of IVF on pregnancy complications and birth outcomes in women of advanced maternal age.

METHODS

In this retrospective study, 3325 women were divided into the ART pregnancy group ( = 241) and the natural pregnancy group ( = 3086). The differences in maternal general conditions, pregnancy complications and birth outcomes were compared between the two groups.

RESULTS

The ART group had higher rates of primiparity (78.4% vs 20.4%), cesarean section (90.5% vs 76.2%) and twin births (28.6% vs 2.1%). The risk of gestational hypertension (5.8% vs 2.9%), preeclampsia (5.0% vs 2.3%) and preterm birth [28 ∼ 31 + 6 weeks (2.9% vs 1.1%), 32 ∼ 33 + 6 weeks (5.0% vs 1.4%), 34 ∼ 36 + 6 weeks (15.8% vs 9.4%)] was significantly higher in the ART group than in the natural pregnancy group. Neonates in the ART group had lower birth weights (2882.61 ± 657.70 vs 3223.05 ± 534.28). However, in the singleton-only comparison, only gestational hypertension still showed a statistically significant difference.

CONCLUSIONS

For women of advanced maternal age, IVF-ET pregnancies may result in higher rates of pregnancy complications and adverse birth outcomes, but this is likely to be due to increased rates of multiple pregnancies.

摘要

目的

探讨体外受精对高龄产妇妊娠并发症及分娩结局的影响。

方法

在这项回顾性研究中,3325名女性被分为辅助生殖技术妊娠组(n = 241)和自然妊娠组(n = 3086)。比较两组产妇一般情况、妊娠并发症及分娩结局的差异。

结果

辅助生殖技术组初产妇比例(78.4%对20.4%)、剖宫产率(90.5%对76.2%)和双胎分娩率(28.6%对2.1%)更高。辅助生殖技术组妊娠期高血压(5.8%对2.9%)、子痫前期(5.0%对2.3%)和早产[28~31⁺⁶周(2.9%对1.1%)、32~33⁺⁶周(5.0%对1.4%)、34~36⁺⁶周(15.8%对9.4%)]的风险显著高于自然妊娠组。辅助生殖技术组新生儿出生体重较低(2882.61±657.70对3223.05±534.28)。然而,在仅单胎的比较中,只有妊娠期高血压仍有统计学显著差异。

结论

对于高龄产妇,体外受精 - 胚胎移植妊娠可能导致更高的妊娠并发症发生率和不良分娩结局,但这可能是由于多胎妊娠率增加所致。

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